POST EXPOSURE PROPHYLAXIS
(PEP)
Sejojo Phaaroe
Objective
• HIV and HIV transmission
• Indicators for PEP
• Pre—requisite for PEP
• -baseline and follow up tests
• Pre-re...
THE TRANSMISSION OF
HIV
How do you become infected with HIV?
UNDERSTANDING HIV / AIDS
H :
I :
V :
HUMAN
IMMUNE DEFICIENCY
VIRUS
HIV is therefore a virus that
breaks down the immune
sy...
 Virus does not survive outside the body
 Cannot enter through intact skin
 Quantity of virus
 Enough time
 Point of ...
You will NOT transmit HIV through:
SOCIAL CONTACT
Shaking hands, swimming, kissing,
hugging, sharing toilet, cutlery
BEING...
HIV can only be transmitted through:
Unprotected sexual intercourse
Infected blood
Intra-venous drugging
Mother-to-child
X...
Unprotected sexual intercourse
HIV Clinical stages at different CD + counts (1993 CDC)
CD 4+ COUNT INFECTIONS NEOPLASIA/
CANCERS
>500 cells/ ml CANDIDIAS...
Where are OIs come from in the health wor
place ?
• Food
– Raw vegetables, fruits
– Raw meat, eggs, poultry
– Stored food,...
WHY PEP?
• There may be a window of opportunity in the first few hours
of days after exposure in which the highly active d...
Indicators for PEP
• Occupational exposure – cut,
• Non occupational exposure
-bite
-Sexual assault
- crime scene attendan...
PEP SERVICE PACKAGE
• behavioural change counselling
• STI testing and treatment
• Pregnancy testing and prevention
PRE-REQUISITE FOR PEP
• Source: HIV TEST- if Available and consent
• Exposed : HIV test
• if test results positive, no PEP...
FOLLOW UP TESTS
-HIV
HBSG 6 WEEKS , 3 MONTHS, 6 MONTHS
REGIMEN
- 3TC = Lamivudine
-AZT= Zidovudine
Add 3rd medicine for high risk exposure
- Kaletra
adherence
• PEP should preferably be stated within 2
hours of the injury and definitely within 72
hours and continue for 2...
summary
• PEP might stop a person from getting infected with HIV
• It must be started as soon as possible after exposure- ...
Thank you
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Post exposure prophylaxis- HEALTH SECTOR WELLNESS SERVICES

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HIV and HIV transmission
Indicators for PEP
Pre—requisite for PEP
-baseline and follow up tests
Pre-requisite for PEP Provision
PEP package
ARV- Treatment and adherence

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Post exposure prophylaxis- HEALTH SECTOR WELLNESS SERVICES

  1. 1. POST EXPOSURE PROPHYLAXIS (PEP) Sejojo Phaaroe
  2. 2. Objective • HIV and HIV transmission • Indicators for PEP • Pre—requisite for PEP • -baseline and follow up tests • Pre-requisite for PEP Provision • PEP package • ARV- Treatment and adherence
  3. 3. THE TRANSMISSION OF HIV How do you become infected with HIV?
  4. 4. UNDERSTANDING HIV / AIDS H : I : V : HUMAN IMMUNE DEFICIENCY VIRUS HIV is therefore a virus that breaks down the immune system within human beings A : I : D : S : ACQUIRED IMMUNE DEFICIENCY SYNDROME AIDS is therefore a collection of many infections in the body as a result of a weakened immune system caused by the HIV Virus
  5. 5.  Virus does not survive outside the body  Cannot enter through intact skin  Quantity of virus  Enough time  Point of entry  Enough Quantity THREE CONDITIONS FOR TRANSMISSION: NO TRANSMISSION BECAUSE:
  6. 6. You will NOT transmit HIV through: SOCIAL CONTACT Shaking hands, swimming, kissing, hugging, sharing toilet, cutlery BEING WITH AN HIV+ PERSON TRAVELLING FOOD AND EATING WORK ENVIRONMENT
  7. 7. HIV can only be transmitted through: Unprotected sexual intercourse Infected blood Intra-venous drugging Mother-to-child X   
  8. 8. Unprotected sexual intercourse
  9. 9. HIV Clinical stages at different CD + counts (1993 CDC) CD 4+ COUNT INFECTIONS NEOPLASIA/ CANCERS >500 cells/ ml CANDIDIASIS CERVICITIES CIN Invasive Cancer of cervix Idiopathic Thrombocytopenia purpura Hodkins Lymphoma Non Hogkins Lymphoma K.S 200-500 TB , Bacterial pneumonia Herpes Zoster Oral candidiasis Oesophagial candidiasis CIN Invasive Cancer of cervix Idiopathic Thrombocytopenia purpura Hodkins Lymphoma Non Hogkins Lymphoma K.S 50- 200 Extra pulmonary TB PCP Cryptococoosis Toxoplasmosis Blastomycetes Septicaemia Herpes Wasting- Anaemia Peripheral Neuropathy Non Hodgkins Lymphoma Cardiomyopathy <50 CMV
  10. 10. Where are OIs come from in the health wor place ? • Food – Raw vegetables, fruits – Raw meat, eggs, poultry – Stored food, unwashed food • Water – Cryptsporidiosis, microsporidiosis • Air – TB, Cryptocococcus
  11. 11. WHY PEP? • There may be a window of opportunity in the first few hours of days after exposure in which the highly active drugs may prevent HIV infection • Immediately following an exposure to blood or body fluids, wounds should be washed with soap and water and should not be squeezed
  12. 12. Indicators for PEP • Occupational exposure – cut, • Non occupational exposure -bite -Sexual assault - crime scene attendants - car accident • Condom breakage
  13. 13. PEP SERVICE PACKAGE • behavioural change counselling • STI testing and treatment • Pregnancy testing and prevention
  14. 14. PRE-REQUISITE FOR PEP • Source: HIV TEST- if Available and consent • Exposed : HIV test • if test results positive, no PEP- the client is advised to go to the HIV clinic to start baseline procedures • Baseline tests- HIV • -PREGNANCY • HBSAG
  15. 15. FOLLOW UP TESTS -HIV HBSG 6 WEEKS , 3 MONTHS, 6 MONTHS
  16. 16. REGIMEN - 3TC = Lamivudine -AZT= Zidovudine Add 3rd medicine for high risk exposure - Kaletra
  17. 17. adherence • PEP should preferably be stated within 2 hours of the injury and definitely within 72 hours and continue for 28 days • Clinicians should closely monitor people receiving PEP to detect ARV- induced dangerous effects
  18. 18. summary • PEP might stop a person from getting infected with HIV • It must be started as soon as possible after exposure- and definitely within 72 hrs ( 3 days) • Strict adherence is essential • Anti-HIV medicine are to be taken for 4 weeks • Side effects are common and can be debilitating • ---- • PEP is not suitable for individuals with repeated high – risk behaviour • Who are not willing to risk reduction practices • Primary prevention remain maintain in control of HIV not PEP
  19. 19. Thank you

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